CMS Announces Computation of Annual Recovery Thresholds

On November 15, 2016 and December 12, 2016, the Centers for Medicare and Medicaid Services (CMS) published a Technical Alert related to recovery thresholds for certain Liability Insurance, No-Fault Insurance, and Workers’ Compensation Settlements, Judgments, Awards or other payments.

Beginning January 1, 2017, CMS said that the threshold for physical trauma-based liability insurance settlements will be reduced to $750. Additionally, CMS said they will maintain the $750 threshold for no-fault insurance and workers’ compensation settlements, where the no-fault insurer or workers’ compensation entity does not otherwise have ongoing responsibility for medical payments.

This means that entities are not required to report, and CMS will not seek recovery on settlements for any settlement less than $750. Please note that the liability insurance (including self-insurance) threshold does not apply to settlements for alleged ingestion, implantation or exposure cases.

For a full reading of the announcement, please click here >>